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From the dentist to the cardiologist: why our mouth is a window into our health
Who hasn’t had toothache or, worse, a dental infection like an abscess or a granuloma at least once in their lives? These common ailments have different causes. One of these is apical periodontitis, a chronic inflammation of the tissues caused by a bacterial infection inside the root canals that develops around the root of the tooth.
It all starts when the bacteria manages to reach the innermost part, the pulp chamber, usually as a consequence of untreated dental caries, a fracture or a trauma. Over time, this process can lead to the destruction of the bone around the root. That’s not all; following a dental infection, bacteria can enter the circulation and damage our general health, creating an inflammatory condition which, in time, can contribute to the onset of diabetes and cardiovascular diseases.
Oral health influences our general health
A study carried out by researchers at King’s College in London and published in the Journal of Translational Medicine has shown how treating dental infections caused by apical periodontitis could help to prevent cardiovascular diseases, diabetes and metabolic syndrome.
As already evidenced in previous studies, chronic inflammation can make it more difficult to control blood sugar levels. At the same time, type 2 diabetes can complicate the healing process following the treatment of the infection, creating a vicious circle. Root canal therapy can help to reduce these risks: the infection is eliminated and with it the risk of it spreading through the body, in most cases avoiding the need to extract the tooth.
The study involved 65 adult patients, with no diseases like diabetes, cardiovascular illnesses or symptoms of metabolic syndrome, being treated for a dental infection at the Guy’s and St Thomas’ NHS Foundation Trust in London. In order to better understand how the body metabolises sugars, fats and other substances in the presence of a dental infection and following treatment, participants underwent blood tests to check their parameters both before and following treatment, at intervals of three months, six months, a year and two years.
Treating dental infections: positive effects on glycaemia, cholesterol and inflammation
Following treatment of the dental infection, patients displayed positive changes that went beyond dental health:
- better management of glycaemia: in the two years following treatment, blood sugar levels fell significantly. A significant finding, because lower blood sugar is closely associated with a lower risk of developing diabetes;
- improved lipid profile: in the short term there was also a fall in levels of cholesterol and fatty acids in the blood, both key indicators of cardiovascular health;
- gradual reduction in the main biomarkers that indicate the presence of systemic inflammation, often associated with cardiac and other chronic diseases.
According to Sadia Niazi, Senior Clinical Lecturer in Endodontics at King’s College, London, and one of the authors of the study, “our findings show that treating dental infections may also help to mitigate cardiometabolic disease risk. It’s a powerful reminder that oral health is deeply connected to overall health. Chronic root canal infections can cause inflammation and increase the levels of glucose and lipids in the blood, raising the risk of serious health issues. On the basis of this evidence, it is essential that dental professionals recognise the wider impact of these infections and advocate for early diagnosis and treatment as part of a truly holistic approach to dental care.”
The findings therefore suggest that oral health possibly has a role to play in reducing cardiometabolic risk, and highlight the importance of monitoring cholesterol and blood sugar levels in patients undergoing treatment for apical periodontitis. Although the study seems to offer a new perspective on the link between oral and general health, broader studies are needed to confirm its findings.
